It is time to change the world of sports medicine by creating a shift in the paradigm of sports medicine from a reactive society to becoming proactive in the way we approach the way injuries occur with athletes.

This all starts with the AMI where our goals are: to screen smarter, move safer, and excel together.

What is AMI?

AMI Overview

The Athlete Movement Index (AMI) is a screen designed to capture the essence of fundamental movements common to all athletes. With the AMI it is possible to uncover movement deficiencies, asymmetries in motor control of the body,along with deficits in mobility and stability that would otherwise go unchecked in conventional screenings. The findings would thus allow for a more in-depth and enhanced evaluation of the athlete prior to the start of sport participation and during eventual return-to-play assessment following injury.

The idea of the AMI started out of the need to assess athletes in a more movement specific manner with a simple to use grading system. In doing so, we are able to assess the athlete on a functional movement standard and not through isolated individual muscle tests. Assessing athletes in this manner does a disservice as a screening process, as the essence of movement is a synchronous and coordinated head-to-toeeffortof all the body’s muscles and bones. For this reason, properly screening an athlete requires the appraisal of the athlete in reference to how they move. In doing so we are able to determine their individual level of stability, coordination and mobilityand how they affect their movement patterns. This allows for an insight into how certain athletes have the ability to play and compete without ever sustaining an injury, while other athletes seem to be extremely prone to injury.

The purpose of the AMI is to be able to therefore provide information on an athlete specific to the way they move, establishing a movement paradigmspecific to the lower extremities, unlike any other screening process to this date. Injuries to the lower body, especially the knees, can be very devastating; resulting in dramatic loss in playing time and possible surgeries. For example, every single year in the United States thousands of athletes tear their anterior cruciate ligament (ACL). This traumatic injury results in required surgical repair and a minimal 6 month of intense physical rehabilitation before return to any athletic participation is possible. This type traumatic injury to the knee, along with a multitude of others sustained by athletes of all sports, all have a similar rooted risk factor: poor movement patterns.

If we are able to assess the way in which each athlete moves, classifying their own personal movement profile or index, we can then discover the missing link in the understanding of how individual movement pattern problems lead to injuries. This understanding then gives us the ability to offer effective prevention programs aimed at notcorrecting for individual muscular weaknesses, but movement deficiencies, effectively targeting the cause of traumatic injury. This leads to not only a decreased risk for future catastrophic injury but also the possibility for improved athletic performance, as the fundamental movements that support physical strength, power and skill are enhanced.

The goal with the AMI is to simply assess the way in which our athletes move with a focus on the lower extremities. By uncovering movement pattern dysfunctions that the conventional pre-participation screens would miss, we are able to illuminate areas of weakness that can then be addressed with properly designed and individualized intervention programs. The goal is to ensure our athletes develop sound movement patterns that allow them to move safely and perform to their physical potential. Screen smarter, move safer, excel together. These are the goals of the AMI.

The AMI Tests

The AMI is comprised of five movement tests that allow us a glimpse into how each individual athlete moves through patterns that require whole body mobility, stability and motor control. The patterns chosen for the AMI are specific to athletic movement requirements regardless of sport. By screening athletes through the chosen screens, we are able to truly see if an athlete has limitations in their movement patterns that would place them at an increased risk for lower extremity injury throughout their competitive season.

The AMI does not use pain reports or isolated strength measures as the sole determinants of athletic readiness for sport and risk for injury. Athletes are programmed early on in their sporting careers to push through pain, many times never seeking or alerting medical professionals of a problem until their performance suffers. In the same fashion, athletes also spend hundreds of hours every single year training their bodies for the physical tortures of sporting competition. In doing so, many athletes at risk for injury will test as if they are completely normal and without dysfunction under conventional isolated strength tests used in many pre participation screenings. For this reason, we need to assess the way an athlete moves in order to truly evaluate and assess the athlete. Dysfunctions in movement will appear far before many athletes have their first symptoms of pain and illuminate those who are at risk for further injury despite an athlete holding back reports of pain in hopes of receiving a passing grade on pre participation screenings.

The AMI is also movement specific, not performance specific. While the screening process will not tell an athlete if he or she can run faster, jump higher, or lift more weight, the ability to perform each screen in an optimal fashion demonstrates whether or not an athlete has the ability and physical aptitude to excel on the field of play in an injury free manner. Scoring poorly on the AMI due to poor movement patterns or asymmetrical movement quality clearly demonstrates that there is a movement deficit for that individual athlete that needs to be addressed. Once addressed and movement quality is improved, the potential for improved athletic physical capacity is possible along with an inherent decrease in risk for injury during competition. The goal of the screening process is not to label an athlete with a specific medical diagnosis, but to discover if individual dysfunctions in movement or pain are present that would place an athlete at increased risk for injury.

Each athlete will go through the five movement tests (deep squat, lateral touch down, single hop for distance, triple crossover hop for distance, and y balance test) and will be scored on a scale from 0 to 3. A score of 3 will be awarded to movement patterns free of compensation and dysfunction. A score of 2 will be assigned to movement patterns that show some smaller compensations or asymmetries, while a score of 1 means the athlete was unable to perform the test without large compensations, loss of balance, or considerable asymmetry. A score of 0 means the athlete reported pain at some time during the testing procedure, regardless of quality of movement, and should be immediately referred for medical council with a specialist for further evaluation.

At the end of the screen, the overall scores from each test are combined to generate the AMI composite score. A maximum score of 15 is possible. For tests that assess symmetry between legs, the lower of the two scores is used for the overall score. This allows the AMI to illuminate athletes who may be at risk for future injury due to asymmetrical movement quality between lower extremities.

Tools Required for Screening

PVC Pipe

This pipe is used as a lightweight bar to hold during the overhead deep squat screen.

2x4 or 2x6 board

This will be used during the overhead deep squat screen if the athlete is unable to show appropriate movement during their first attempt to receive a score of three. The board (2 inches in height) is used to incline the heels for the second attempt of the movement.

Y Balance Kit

This will be used for all three Y balance screening movements.

Tape Measure

This will be used to measure distance hopped during the single hop and triple crossover hop screens.

8 Inch Box

This will be used during the lateral touch down step. If a box is not available, a staircase step may be used.

Overhead Deep Squat Screen

The overhead deep squat movement is one of the most important functional movement patterns an athlete perform. It requires an athlete to show adequate control of much needed full range of motion in the ankles, knees, and hips while at the same time maintaining proper core stability with the arms in an overhead elevated position.

Lateral Touch Down Screen

Many traumatic injuries to the lower extremities happen during thedeceleration phase of movement such as when changingdirection, cutting maneuvers,or when the athlete is landing from a jump.9In fact, research has shown that regardless of gender at least ⅔ of all ACL tears occur during this deceleration phase and without any contact with another athlete.17,18

Single Hop for Distance Screen

Hop testing has been one of the most widely used screens to assess the rehabilitation process for athletes returning from ACL reconstruction since its introduction in the early 1980’s. The single leg hop for distance screen is asimple to administer test that allows a trained individual an easy insight into the dynamic readiness of an athlete to return to the rigors of sport.

Triple Crossover Hop for Distance Screen

When the triple crossover hop for distance is combined with the single hop for distance test a more thorough evaluation of the athlete is accomplished, allowing testers to get an even better illuminationof any problematic factors that may place an athlete at increased risk for injury. Simply stated, by using two single leg hopping tests versus only one, we are able to better identify athletes who are at risk for injury and require additional interventions.18

Y Balance Screen

Research has shown that poor balance places athletes at an increased susceptibility to injury.21-23 Even more, an asymmetry between legs in balance ability can lead to a significant increase in risk of injury as a deficit in balance in one leg places the athlete instantly at a stability disadvantage if during competition they are called to rely on that extremity.